2. The local treatment depends upon the degree of freezing. Should there be chilblains with uninjured surface, where the skin is apparently intact, painting with 10 per cent. ichthyol oil or 10 per cent. Peru balsam, is advisable. If a salve bandage is applied, we use zinc paste with the following salve: 10 per cent. ichthyol, 10 per cent. Peru balsam and 10 per cent. camphor; or ichthyol 5.0 Gm., Peru balsam 3.0 Gm., camphor 0.3 Gm., naphtalan ad 50.0 Gm.. which is very efficacious. The well known salve of nitrate of silver 1.0 (15 gr.), balsam of Peru 2.0 Gm. (30 gr.), ung. zinc. ad 20.0 Gm. (1 oz.) is also to be recommended. The treatment is best arranged so that the painting is applied in the morn ing, while the salve bandage is kept on over night, a foot bath having been given before applying it.
Open, eroded or ulcerative chilblains demand an irritating ointment which stimulates granulation. Camphor 0.0 per cent.), airolvaseline (10 per cent.), protargol, or nitrate of silver (10 per cent.) ointments are beneficial.
3. The treatment of the general condition consists in prescribing for the aniemia and ordering an invigorating diet. The following internal medication is recommended: Syrup of the iodide of iron, lodide-ferratose (Bohringer), and all iron preparations. Fellow's syrup of hypophos phites and its German substitutes, the well-known tinctures of iron, arsenic, quinine, also strychine pills. lehthyol capsules [twice daily 0.2 Gm. (3 gr.)] or its substitute Ichthalbin. The medicinal treatment also includes dietetic curative procedures (massage, hydrotherapy) and body exercises which are apt to stimulate the circulation.
4. By way of prophylaxis special care should be taken to avoid exposure to cold (cold floor in dwellings, prolonged skating, simultaneous exposure to wet and cold). During the summer, especially in the first years following the illness sys tematic treatment by baths and ointments placed over the affected parts should be insti tuted whenever there is a slight change in temperature.